ArticlePediatric transplantation2026
Use of En Bloc Kidney Allografts for Pediatric Kidney-Alone and Multiorgan Transplant Recipients in the United States.
Article in Pediatric transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEn bloc kidney transplantation is controversial, but recent adult studies increasingly show outcomes that are similar to or superior to those of high-quality single kidney transplants. The use of en bloc allografts in children in the modern allocation era has not been reported.
methodsWe compared SRTR data on en bloc kidney transplants in pediatric recipients 2000-2014 and 2015-2024 to better understand trends in utilization and outcomes in pediatric recipients.
resultsThere were 176 en bloc transplants in pediatric recipients, 138 in the 2000-2014 era, and 38 in the 2015-2024 era. 43.7% of en bloc transplants were part of a multiorgan transplant. Between 2013 and 2024, there was a decreasing use of en bloc allografts overall and specifically for kidney-alone recipients. En bloc kidney-alone transplants had decreased graft survival compared with single kidney transplants in the first year posttransplant, but similar outcomes thereafter. En bloc kidney-multiorgan transplants had superior graft survival after 1 year posttransplant compared with single kidney-alone transplants.
conclusionUtilization of en bloc kidneys has declined in pediatric recipients but can have good outcomes in a select population. More information is needed to understand whether and how best to use en bloc kidney transplantation for adolescents with reduced access to transplant.
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